title: Prognosis and course of disability in patients with chronic nonspecific low back pain: a 5- and 12-month follow-up cohort study.
abstract: BACKGROUND
  Few data are available on the course of and predictors for disability in patients with chronic nonspecific low back pain (CNSLBP).
  
  
  OBJECTIVE
  The purpose of this study was to describe the course of disability and identify clinically important prognostic factors of low-back-pain-specific disability in patients with CNSLBP receiving multidisciplinary therapy.
  
  
  METHODS
  A prospective cohort study was conducted.
  
  
  METHODS
  A total of 1,760 patients with CNSLBP who received multidisciplinary therapy were evaluated for their course of disability and prognostic factors at baseline and at 2-, 5-, and 12-month follow-ups. Recovery was defined as 30% reduction in low back pain-specific disability at follow-up compared with baseline and as absolute recovery if the score on the Quebec Back Pain Disability Scale (QBPDS) was ≤20 points at follow-up. Potential prognostic factors were identified using multivariable logistic regression analysis.
  
  
  RESULTS
  Mean patient-reported disability scores on the QBPDS ranged from 51.7 (SD=15.6) at baseline to 31.7 (SD=15.2), 31.1 (SD=18.2), and 29.1 (SD=20.0) at 2, 5, and 12 months, respectively. The prognostic factors identified for recovery at 5 and 12 months were younger age and high scores on disability and on the 36-Item Short-Form Health Survey (SF-36) (Physical and Mental Component Summaries) at baseline. In addition, at 5-month follow-up, a shorter duration of complaints was a positive predictor, and having no comorbidity and less pain at baseline were additional predictors at 12-month follow-up.
  
  
  CONCLUSIONS
  Missing values at 5- and 12-month follow-ups were 11.1% and 45.2%, respectively.
  
  
  CONCLUSIONS
  After multidisciplinary treatment, the course of disability in patients with CNSLBP continued to decline over a 12-month period. At 5- and 12-month follow-ups, prognostic factors were identified for a clinically relevant decrease in disability scores on the QBPDS.
authors.affiliation: K. Verkerk, PT, MSc, Institute of Healthcare, Rotterdam University of Applied Sciences, Rotterdam, the Netherlands; Spine & Joint Centre, Rotterdam, the Netherlands; and Department of General Practice, Erasmus MC, University Medical Center, Rotterdam, the Netherlands. Mailing address: Rochussenstraat 198, 3015 EK, Rotterdam, the Netherlands.
authors.forename: Karin
authors.initials: K
authors.lastname: Verkerk
authors.forename: Pim A J
authors.initials: PA
authors.lastname: Luijsterburg
authors.forename: Martijn W
authors.initials: MW
authors.lastname: Heymans
authors.forename: Inge
authors.initials: I
authors.lastname: Ronchetti
authors.forename: Annelies L
authors.initials: AL
authors.lastname: Pool-Goudzwaard
authors.forename: Harald S
authors.initials: HS
authors.lastname: Miedema
authors.forename: Bart W
authors.initials: BW
authors.lastname: Koes
mesh_terms: D000328:Adult; D000368:Aged; D059350:Chronic Pain / Q000175:diagnosis* / Q000628:therapy; D015331:Cohort Studies; D004185:Disability Evaluation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D017116:Low Back Pain / Q000175:diagnosis* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D018710:Pain Clinics; D059408:Pain Management / Q000379:methods; D010147:Pain Measurement; D011379:Prognosis; D011446:Prospective Studies; D012044:Regression Analysis; D016896:Treatment Outcome